20 December 2013 – Bus crash, Kennington Road

Kennington bus crash

20 December 2013

We were called at 10.50am to reports of a road traffic collision involving a bus and tree at the junction of Kennington Road and Lollard Street, SE11.

A number of staff were sent to the scene including seven ambulance crews, three single responders in cars, five duty officers, London’s Air Ambulance and our hazardous area response team.

We treated 32 patients in total, who were taken to three London hospitals – St George’s Hospital, King’s College Hospital and St Thomas’ Hospital.

Twenty-five were walking wounded with cuts and bruises. Five suffered more serious injuries, such as head and leg injuries.

Two further patients – a man and a woman who were trapped in the bus – suffered serious leg injuries.

Duty Station Officer Lee Hyett-Powell said: “There were a large number of patients for our staff to care for but all of the emergency services worked well together to ensure that they were assessed and treated as quickly as possible.

“We worked with the fire brigade to get to the two patients who were trapped on the upper deck. They had suffered the most serious injuries and were trapped on the bus for around two hours. We treated and stabilised them while they were being released before taking them to hospital.”

-ENDS-

Bus crash in Kennington

20 December 2013

Firefighters were called to deal with a double decker bus that had collided with a tree on Kennington Road in Kennington this morning.

Station Manager Clive Robinson, who was at the scene, said:

“This was a particularly nasty crash and our crews worked extremely hard in very challenging circumstances to get the passengers off the bus. We used ladders to get some of the people out and in the case of the final two passengers trapped on the top deck crews had to shore up the upper floor which had started to collapse before using specialist cutting gear to release them. The man and woman were then lowered to the ground on a stretcher by firefighters on a turntable ladder.”

A total of 32 people were injured and taken to hospital.

Four fire engines from Soho, Westminster, and Lambeth fire stations attended the crash along with two fire rescue nits from Battersea and Chelsea. London Ambulance Service, the air ambulance, and the Metropolitan police were also at the scene.

The Brigade was called at 1052 and the incident was over by 1350.

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King’s College Hospital (Major Trauma Centre)

Header_Logo-kingsThey are home to one of London’s four Major Trauma Centres (MTCs), meaning patients with life-threatening injuries are transferred to them by paramedics or air ambulance for specialist treatment.

Their Emergency Department (ED) treats more than 120,000 patients every year, and is the subject of Channel 4’s 14-part primetime series 24 Hours in A&E, which features the staff and the patients they treat.

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The Royal London Hospital (Major Trauma Centre )

barthealtBarts Health provides vital, life-saving trauma services to the local communities in east London and further afield. The Major Trauma Centre at The Royal London Hospital is a leading specialist centre with an international reputation for caring for some of the most seriously injured patients across London. It is also the home of London’s Air Ambulance.

Barts Health has local trauma units at Newham University Hospital and Whipps Cross University Hospital have dedicated facilities and teams to deliver high quality, clinical care to patients with less serious injuries.

Trauma refers to any damage to the body due to a physical injury or accident – and this is the leading cause of death among children and adults aged 44 and under. Barts Health treat patients with multiple injuries resulting from road traffic accidents, falls and violent crimes such as assault and gun/knife crime. Whether you’re a patient, relative, friend or a healthcare professional looking for advice a team of specialists are there to support you.

Responding to a major incident

Barts Health is a leader in the field for developing effective, efficient, coordinated disaster response systems. Over the last few decades, their clinical teams across the trauma service have been involved in the management of various major incidents, including the London bombings in 2005, the nail-bombing attack in Soho in 1999, and the terrorist bombings in Bishopsgate in 1993.They have developed and put in place action plans for dealing with emergency situations.

Their plans, which can be implemented 24 hours a day, 365 days a year, aim to save lives, relieve suffering and minimise the long-term effects on health.

The aim is to be prepared for emergencies, crises and disasters of any kind. These range from localised fires and explosions to large-scale terrorist attacks.

The Royal London Hospital leads the north east London and Essex trauma network and cares for a population of over five million people. The team works collaboratively with partner units and rehabilitation services to ensure that every patient receives the best care possible – with the optimum outcome.

They have a dedicated trauma ward where patients benefit from coordinated care from surgical, nursing and therapies staff. In addition to providing fast access to individual specialists, we conduct a multidisciplinary ward round involving all relevant disciplines and clinical teams, to ensure that every patient’s treatment is as good as it can possibly be.

Operations are scheduled so that different teams of surgeons can operate on a patient’s various injuries in one theatre session – this can reduce their time in hospital and promote faster rehabilitation.

Their clinicians have pioneered trauma care in the UK and The Royal London is at the heart of a London-wide network of trauma centres, offering world-class clinical care for people living and working in the capital. We are also well known for our leading research and training.

They are part of a large, specialist teaching hospital trust, and able to call on experts from a wide range of specialist areas. This ensures that their patients receive the very best treatment for each of their individual injuries.

Specialists from the following areas are on hand to treat our trauma patients:

• Cardiothoracic surgeons
• Ear, nose and throat specialists
• General trauma and vascular surgeons
• Maxillofacial surgeons
• Neurosurgeons
• Obstetrics and gynaecologists
• Ophthalmologists
• Orthopaedics
• Psychiatrists
• Plastic surgeons
• Radiologists
• Urologists

Trauma patients are usually taken to the most appropriate location by the ambulance team.

• Local trauma units
• Major trauma centre
• Trauma care
• Support following trauma care

Local trauma units

Patients who attend one of our local trauma units will be seen and assessed quickly via the specialists who are based in the Emergency Department. Treatment will begin soon after arrival. If a patient requires surgery, Barts Health has emergency operating theatres that are available 24 hours a day, seven days a week.

A specialist team cares for patients with traumatic injuries, which are not life-threatening or limb-threatening. This may include minor head injuries and broken bones.

Major trauma centre

Barts Health is one of three designated major trauma centres serving the capital. Patients attending a major trauma centre will be cared for by a team of dedicated consultants from various specialities assigned to look after specific injuries. If a patient requires surgery they have emergency operating theatres that are available 24 hours a day, seven days a week. Patients requiring emergency, life-saving surgery are identified within minutes of arrival in the resuscitation room and transferred immediately to the operating theatre.

Patients who have been seriously injured can lose large volumes of blood and may require emergency life-saving blood transfusions. Co-ordinated care from the roadside to the emergency department means doctors at the scene can radio ahead for blood, prepare the trauma team and ensure blood and blood-clotting products are immediately available on arrival at the hospital.

Trauma care

Ambulance crews use an agreed protocol to take injured people to the hospital most suited to their needs. The most seriously injured will be taken to a major trauma centre – such as The Royal London Hospital. The majority of people will receive treatment in their local trauma unit. If patients arrive in a trauma unit and then require the specialist services of a major trauma centre they will be stabilised and transferred immediately to the major trauma centre for treatment.

Patients who need to stay one of our trauma units will be cared for on the general surgery ward or orthopaedic ward, depending on their needs. They will be seen by specialist surgical, nursing and therapies teams.

If you are receiving care in one of their trauma centres, then they will spend time with you, and the people closest to you, to discuss your treatments and the process for your recovery. They will talk to you about the dangers and long-term implications of certain injuries. You will be offered support and advice from a wide range of professionals who have expertise in caring for traumatic injuries.

Support following trauma care

Their aim is not only to save lives, but to do all they can to help patients to return to their normal lives. To help achieve this, they provide comprehensive support and therapeutic care, including occupational therapy and physiotherapy.

Allied health professionals from many disciplines are routinely involved in the care and rehabilitation of trauma service patients. They play a key role in assessment and early rehabilitation after traumatic injury. Our therapy teams help people to recover from their injuries during their hospital stay. In some cases, patients go straight home following their stay, but other may need further rehabilitation either in specialist units or from teams closer to home (as an inpatient or within the community). In all cases, the allied health team members will help to guide the patient and others in the team in deciding what should happen. They will often get involved in making referrals to teams in other organisations to ensure that the patient achieves their maximum independence.

If a patient is treated at the Major Trauma Centre at The Royal London Hospital, they may be transferred back to the care of their local hospital for their on-going therapy and rehabilitation.

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19 December 2013 – Apollo Theatre incident, Shaftesbury Avenue

Apollo theatre incident – 10pm

19 December 2013 – 22.00

“We were called just after 8.10pm to the Apollo Theatre in Shaftesbury Avenue.

“We have sent a large number of staff to the scene, including 25 ambulance crews, 12 officers, members of our hazardous area response team and a medical team from London’s Air Ambulance also attended in a car.

“We have been working closely with the other emergency services to treat the injured.

“We have now treated 88 patients, of whom 81 had suffered minor injuries and were walking wounded.

“Seven patients with more serious injuries have also been treated and taken to hospital.”

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Apollo Theatre update

19 December 2013

To be attributed to a London Ambulance Service spokesperson:

We were called just after 8.10pm to the Apollo Theatre in Shaftesbury Avenue.

We sent a large number of staff to the scene, including 25 ambulance crews, 12 officers, members of our hazardous area response team and a medical team from London’s Air Ambulance also attended in a car.

Our first staff arrived within three minutes and we worked closely with the other emergency services to care for the injured.

We treated 76 patients, of whom 58 were subsequently taken to one of four hospitals – St Mary’s Hospital, University College Hospital, St Thomas’ Hospital and St George’s Hospital.

Of these, 51 had suffered minor injuries and were walking wounded and seven had suffered more serious injuries.

Incident Commander Maria Smith, who was one of the first on scene, said: “When I arrived it was dark and extremely dusty and people were lying on the floor of the theatre.

“We very quickly set up a casualty clearing area in the foyer of the theatre and the walking wounded were assessed and treated there for injuries such as cuts and grazes, breathing problems and head injuries.

“All the staff involved did an excellent job to help ensure that people received medical attention and those who needed further treatment were taken to hospital.”

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St Mary’s Hospital treats 11 casualties after incident at Apollo Theatre – 20 December 2013

St Mary’s Hospital, Paddington, received 11 casualties following the incident at the Apollo Theatre. One patient was admitted and is receiving further treatment.

The majority of the patients were walking wounded and were treated for facial lacerations, minor hand fractures, minor head injuries, and minor wounds.

If you are concerned about a family member, please call the Police Casualty Bureau on 020 7230 1212.

Ambulance Service’s response to Apollo Theatre incident

20 December 2013

To be attributed to a London Ambulance Service spokesperson:

We were called just after 8.10pm to the Apollo Theatre in Shaftesbury Avenue.

We can now confirm that we sent a total of 54 resources to the scene. These included:
29 ambulance crews
Seven responders in cars or on motorbikes
18 officers and other vehicles, including members of our hazardous area response team and a medical team from London’s Air
Ambulance who also attended in a car.

Our first staff arrived within three minutes and we worked closely with the other emergency services to care for the injured.

By the time the scene had been completely cleared, we had treated 79 patients.

Of these, 56 were subsequently taken to hospital – 47 had suffered minor injuries and were categorised as being walking wounded, and nine had suffered more serious injuries including head and back injuries.
35 patients were taken to St Thomas’ Hospital (32 walking wounded and three more serious)
10 patients were taken to St Mary’s Hospital (Nine walking wounded and one more serious)
Nine patients were taken to University College Hospital (Five walking wounded and four more serious)
Two patients were taken to St George’s Hospital (One walking wounded and one more serious)

Among the vehicles used to transport patients with minor injuries were two London buses.

Incident Commander Maria Smith, who was one of the first on scene, said: “When I arrived it was dark and extremely dusty and people were lying on the floor of the theatre.

“We very quickly set up a casualty clearing area in the foyer of the theatre and the walking wounded were assessed and treated there for injuries such as cuts and grazes, breathing problems and head injuries.

“All the staff involved did an excellent job to help ensure that people received medical attention and those who needed further treatment were taken to hospital.”

– Ends –

London Fire Brigade: Ceiling collapse at Soho theatre 19 December 2013

The London Fire Brigade was called at 2014 yesterday evening to reports of a collapsed ceiling at a theatre on Shaftesbury Avenue in Soho.

Eight fire engines and specialist rescue vehicles attended the incident and over 50 firefighters worked at the scene with colleagues from the Met Police and London Ambulance Service. Fire engines came from Kensington, Soho, Westminster, Dowgate, Southwark, Knightsbridge, Battersea, Lambeth, and Euston stations. Fire rescue units came from Battersea, East Ham, Edmonton, and Chelsea fire stations.

Kingsland Station Manager Nick Harding, who attended the theatre incident, said:

“We believe around 720 people were in the theatre at the time. A section of the theatre’s ceiling collapsed onto the audience who were watching the show. The ceiling took parts of the balconies down with it.

“Firefighters worked really hard in very difficult conditions and I’d like to pay tribute to them. They rescued people from the theatre, made the area safe and then helped ambulance crews with the injured.

“Specialist urban search and rescue crews were also called to the scene to make sure no one was trapped. Fortunately all those who were trapped were rescued and treated for injuries or taken to hospital.

“London Ambulance Service treated 76 patients, 58 of whom were taken to hospital to be treated for their injuries. Fifty one of these were walking wounded and seven had more serious injuries.

“In my time as a fire officer I’ve never seen an incident like this. I imagine lots of people were out enjoying the show in the run-up to Christmas. My thoughts go out to all those affected.”

The Brigade’s specialist Urban Search and Rescue (USAR) advisors have offered structural advice and guidance to the theatre.

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The London Ambulance Service

Header_Logo-templante-lasThe London Ambulance Service is the busiest emergency ambulance service in the UK to provide healthcare that is free to patients at the time they receive it. The London Ambulance Service is also the only London-wide NHS trust.

The London Ambulance Service has over 4,500 staff, who work across a wide range of roles based in 70 ambulance stations. The London Ambulance Service serves more than seven million people who live and work in the London area.

The main role is to respond to emergency 999 calls, providing medical care to patients across the capital, 24 hours a day, 365 days a year. The London Ambulance Service has responded to many major incidents in London, the most notable in recent years being the bombings on 7 July 2005 and the Paddington train crash.

During a large-scale incident of this nature, they work closely with other emergency services and organisations in London to save lives.

The responsibilities include:

  • putting hospitals in London on alert to receive patients;
  • setting up a system at the scene for prioritising and treating patients based on their medical needs;
  • treating, stabilising and caring for people who are injured; and
  • taking patients who need further treatment to hospital.

The London Ambulance Service operates over an area of approximately 620 square miles, from Heathrow in the west to Upminster in the east, and from Enfield in the north to Purley in the south.

Station (Code), Address

South area
Barnehurst (L1) 164 Erith Road, Bexleyheath, Kent, DA7 6BZ
Battersea (Q1) 119 Battersea Rise, London SW11 1HW
Beckenham (M4) 12 Beckenham Road, Beckenham Kent BR3 4LR
Brixton (Q2) Unit 25 Bessemer Park, 250 Milkwood Road, London SE24 0HG
Bromley (M1) Crown Lane, Bromley Kent BR2 9PW
Coulsdon (P1) Unit 21, Ullswater Crescent, Coulsdon, CR5 2HR
Croydon (M2) 168 Primrose Lane, Croydon CR0 8YY
Deptford (N1) 1 New Cross Road, London SE14 5DS
Forest Hill (N6) 51 Davids Road, London SE23 3EP
Greenwich (L2) 392 Shooters Hill Road, London SE18 4LP
Lee (N4) 142 Lee High Road, London, SE13 5PR
New Malden (S1) Wellington Crescent, New Malden Surrey KT3 3NP
Mottingham (L3) 205 Eltham Road, London SE9 5LN
New Addington (M3) Lodge Lane, New Addington, Croydon CR0 0QA
Oval (Q3) Foxley Road, London SW9 6ES
Putney (Q4) 48 West Hill London SW18 1RX
Richmond (S2) 73 Kings Road, Surrey TW10 6EG
Rotherhithe (N2) Ann Moss Way, Lower Rd, London SE16 2TG
South Croydon (P2) 123 Waddon Way, South Croydon CR0 6MD
St Helier (R1) Bishopsford Road, Morden Surrey SM4 6BN
St Pauls Cray (L4) Chipperfield Road, St Pauls Cray, Kent BR5 2PZ
Streatham (P3) Mountearl Gardens, London SW16 2NN
Sutton (R2) Dorset Road, Sutton SM2 6JH
Tolworth (S3) Ewell Road, Tolworth, Surrey KT6 7DX
Waterloo (N3) 2 Frazier Street, London SE1 8SD
Westminster (F1) Causton Street, London SW1 4AT
Wimbledon (R3) Nursery Road, Wimbledon SW19 4JA
Woolwich (L5) Ferry Approach, London SE18 6DP
East area
Becontree (K2) Goresbrook Road, Dagenham, Essex RM9 6XP
Bounds Green (H2) Bounds Green Road, London N22 4DF
Chase Farm (H1) The Ridgeway, Enfield, Middlesex EN2 8JR
Edmonton (H3) Windmill Road, London N18 1NJ
Homerton (G3) 126 Homerton High Street, London E9 6JA
Hornchurch (K5) St Georges Hospital, Suttons Lane, Essex RM12 6RS
Ilford (K3) Aldborough Road South, Ilford Essex IG3 8HQ
Newham (K1) Wellington Road, London E6 2RG
Ponders End (H4) Carterhatch Lane, Enfield Middlesex EN1 4LA
Poplar (J1) Harford Street, London E1 4PQ
Romford (K4) Oldchurch Road, Romford Essex RM7 0AD
Shoreditch (G4) Basing House Yard, Kingsland Road, London E2 8AE
Silvertown (J5) 291 North Woolwich Road, Silvertown London E16 2BB
Smithfield (G5) West Smithfield, London EC1A 9HY
Tottenham (H5) St Anns Road, London N15 3TH
Walthamstow (J4) Wadham Road, London, E17 4HR
West Ham (J2) Howards Road, Plaistow, London E13 8AZ
Whipps Cross (J3) James Lane, London E11 1NU
West area
Barnet (D2) 144 Station Road, Barnet Herts
Bloomsbury (E1) 19 Herbrand Street, London WC1N 1HP
Brent (C3) Unit 2-3 Falcon Park, Neasden Lane, London NW10 1RZ
Camden (E3) Cressey Road, London NW3 2NA
Chiswick (C2) 368 Goldhawk Road, London W6 0XF
Feltham (A1) Faggs Road, Feltham, Middlesex TW14 0LZ
Friern Barnet (D4) Colney Hatch lane, London N11 3DG
Fulham (F2) 150 Seagrave Road, London SW6 1RX
Greenford (B1) Greenford Road, Middlesex UB6 8RQ
Hanwell (B3) Boston Road, London W7 3SA
Hayes (B2) Church Road, Hayes. Middlesex UB3 2LG
Heathrow Airport (A4/A5) Building 450, Northern Perimeter Rd, North Side, Heathrow Airport, Hounslow TW6 2RR
Heathrow Airport – Cycle response unit (B4) Sipson Way, West Drayton, Middlesex UB1 0DP
Hillingdon (B5) Royal Lane, Hillingdon Middlesex UB8 3QX
Isleworth (A2) Mogden Lane, Isleworth, Middlesex TW7 7LJ
Islington (G1) 88 Brewery Road, London N7 9NT
Kenton (C1) The Mall, Kenton, Harrow HA3 9TD
Mill Hill (C8) Hartley Avenue, London NW7 2HX
Nth Kensington (C4) 20 Malton Road, London W10 5UP
Pinner (B6) Imperial Drive, Harrow, Middlesex HA2 7HD
Ruisilip (B7) Northwood & Pinner Community Hospital, Pinner Road, Northwood, Middlesex, HA6 1DE
St Johns Wood (E2) Lyons Place, London NW8 8NL
Twickenham (A3) South Road, Twickenham, Middlesex TW2 5NT
Wembley (C6) Wembley Hospital, Chaplain Road, Wembley HA0 4TX

In addition to 70 ambulance stations across London, the London Ambulance Service has headquarters at the following locations:

Waterloo Road
Pocock Street
Loman Street
Fielden House
Bow

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London’s Air Ambulance

Header_Logo-templante-airambLondon’s Air Ambulance is the Charity that delivers an advanced trauma team to critically injured people in London. The service provides pre-hospital medical care to victims of serious injury, at the scene of the incident – serving the 10 million people who live, work and commute within the M25.

Based at the Royal London Hospital and founded in 1989, the service is unique in that it operates 24/7, with the helicopter running in daylight hours and rapid response cars taking over at night.

The Team, which at all times includes a Senior Trauma Doctor and a specially trained Paramedic, perform advanced medical interventions, normally only found in the Hospital Emergency Department, in time critical, life threatening situations. Missions commonly involve serious road traffic collisions, falls from height, industrial accidents, assaults and injuries on the rail network.   London’s Air Ambulance has an international reputation for clinical excellence and delivers pioneering procedures which have been adopted across the world.

London’s Air Ambulance was the first air ambulance service in the UK:

  • with a doctor and paramedic team;
  • to deliver high standard pre-hospital anaesthesia;
  • to have a clinical governance programme;
  • to perform a thoracotomy (open heart surgery) at the roadside;
  • to perform thoracostomy (to drain collapsed lungs);
  • to use check lists to improve patient safety;
  • with air & land based response; and to provide 24 hour cover.

The Helicopter

London’s Air Ambulance operates an MD902 Explorer twin engine helicopter, one of the most identifiable in the world. This is one of a new generation of aircraft chosen for its safety features which include no tail rotor, important in an urban environment.  It has been specially adapted for its purpose, to enable patients to be treated to the standard of an intensive care unit in flight.

From it’s helipad at the top of the Royal London Hospital, the Helicopter can reach the furthest points of the M25 within 12 minutes.   Each flying team consists of a senior trauma doctor, a paramedic, two pilots (one of whom acts as a navigator), and an observer (usually a doctor or paramedic completing their first month with London’s Air Ambulance, training for their role).

The Helicopter’s main use is to get this specialist trauma team to the patient in the quickest possible time – the team can be airborne within 2-3 minutes of receiving a call.  The doctor and paramedic will treat the patient, performing operations and procedures that are normally only seen in the hospital emergency department.  Once the patient is stabilised they will be taken to the nearest hospital best equipped to deal with the injuries.  The helicopter is equipped to take a patient to the hospital but this is not always the case. Often  the patient will travel by London Ambulance Service accompanied by the air ambulance team.

The Helicopter’s medical team is equipped with a substantial range of drugs, emergency surgical kits, monitors and other equipment ‘a mini Accident & Emergency Department (A&E) of their own’ so that they can begin treatment straight away.  

MD902 Specifications:
Reg: G-EHMS
Hull No: 68
Max all up weight: 6250 lbs
Engines: 2 Pratt and Whitney 206e
Top speed: 140 kts
Mission ready endurance: 1 hour from the Helipad (130 miles)

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The Rapid Response Cars

When the Helicopter is offline – either at night when it is too dangerous to land in London, or if there are dangerous weather conditions – the operation is supported by a rapid response car team which ensures 24 hour care to London.

The rapid response cars also carry a senior trauma doctor and a specially trained paramedic to the scene of the injury in the quickest time possible. The Rapid Response team will treat the patient on scene, carrying out procedures normally only found in the emergency room. The Rapid Response team patrol London awaiting a call from the London Ambulance Service’s control room to send them to a serious case.  The rapid response cars attend the same types of serious incidents as the Helicopter.

The Rapid Response team is equipped with a substantial range of drugs, emergency surgical kits, monitors and other equipment ‘a mini Accident & Emergency Department (A&E) of their own’ so that they can begin treatment straight away.

London’s Air Ambulance has six Skoda Octavias.  All cars are equipped with blue lights, high visibility strips and badges to identify the car as part of the London’s Air Ambulance fleet.

Blue Light Drivers at London’s Air Ambulance undergo a five day training course under blue light conditions. The training also includes Vehicle Daily Inspection (VDI), Ground Escorting and a written Highway Code Driving Test.  London’s Air Ambulance has its own internal driving licence.

Vehicle Specifications
Engine: 2.0tFSI 200 BHP
Type: 4 cylinder in line engine
Valves per cylinder: 2 Transverse Mounted Multi point fuel injection turbo
Cubic cap: 1.984
Bore stroke: 82.5 x 92.8
Max speed: 149mph 0 to 62 mph: 7.3 seconds

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London’s trauma system

Header_Logo-templantetrofficeLeading London’s new, world-class trauma system

People who suffer serious injury (which is known as major trauma) need the highest quality specialist care to give them the best chances of survival and recovery. From 2010, Londoners will receive new world-class trauma care through the London trauma system. The system is made up of four trauma networks, each with a major trauma centre for treating the most seriously injured patients, linked in with a number of local trauma units for treating those people with less serious injury. The system will save about 100 lives a year and prevent disability for many more.

Ambulance crews will use an agreed protocol to take injured people to the hospital most suited to their needs. The most seriously injured will be taken to a major trauma centre . The majority of people will continue to receive treatment in their local trauma unit. If patients arrive in a trauma unit and then require the specialist services of a major trauma centre they will be stabilised and transferred immediately to the major trauma centre for treatment.

The National Clinical Director for Trauma Professor Keith Willett is highly supportive of the new London trauma system.

“The launch of the London trauma networks represents the culmination of extensive planning and co-operation contributed to by patients, commissioners, managers and many disciplines of clinical staff. These networks will not only be of significant benefit for the severely injured patients of London but will be used extensively across the rest of NHS England as those areas roll out their regional networks for major trauma over the next 2 years. Their strength will lie in the professional consensus that has been achieved and the “can-do” attitude of all those involved. We keenly await the benefits for patients.”

About the system

London’s new trauma system has been designed to ensure that seriously injured patients in the capital receive world-class specialist care. This is achieved through a network of four major trauma centres, located at The Royal London Hospital (Whitechapel), King’s College Hospital (Denmark Hill), St George’s Hospital (Tooting) and St Mary’s Hospital (Paddington). There, specialist teams provide treatment for major trauma injuries 24 hours a day, seven days a week. These centres are supported by a number of trauma units located in A&E departments, where patients with less serious injury will receive their treatment.

Progress

Three leading trauma specialists – Professor Keith Willett (National Clinical Director for Trauma), Professor Keith Porter (Professor of Clinical Traumatology at University Hospital Birmingham) and Lieutenant Colonel Adam Brooks (Consultant Surgeon for both the NHS and the army) – carried out an external assessment in January 2010 of the London trauma system’s readiness for operation. This process gave the assurance that the system was ready to deliver along the agreed timeframes. Following this, the Royal London Hospital, King’s College Hospital and St George’s Hospital will go live and accept major trauma patients in April 2010 with St Mary’s going live in October 2010.

Training

A large number of training courses have been run in preparation for the opening of the system. Around 200 staff have received training in Advanced Trauma Life Support© where actors are used to help train medical teams in trauma management. This uses a number of protocols to ensure care is delivered effectively. A number of surgeons have attended the Definitive Trauma Surgical Skills course run by the Royal College of Surgeons which teaches the surgical techniques required for dealing with life-threatening injuries.

Fifty staff attended the Emergency Management of Severe Burns course to learn the skills required when dealing with people who have sustained severe burns. Nurses and therapists have been attending specialist trauma and rehabilitation training to enable them to care effectively for trauma patients. Nearly 100 diagnostic specialist staff have received training in radiology for trauma.

A number of courses are being developed in London to support the teams who will be treating patients. The trauma team leader course will equip the doctors who will initially stabilise seriously injured patients coming into A&E.

All four trauma networks have been funded to purchase advanced trauma simulation equipment to enable teams to practice and learn in simulated trauma scenarios. This allows development of advanced skills in a classroom environment with time for practice and improvement in trauma skills.

Major incident planning

The establishment of trauma networks will help to facilitate delivery of the London major incident plan. The team has been working closely with NHS London’s Department of Emergency Preparedness to plan the best way of achieving this goal. In addition, a table-top exercise was held in March where the networks practised their response to a number of large scale scenarios involving large numbers of injured patients. This exercise also had representation from London Ambulance Service, ambulances services adjacent to London, police and fire brigade, and senior representatives from NHS London acting as the command and control. Services such as paediatric retrieval and burns and the helicopter emergency service were in attendance to provide specialist input. The exercise produced a lot of helpful information which is being incorporated into the emergency planning response in London to utilise the trauma networks effectively in such a scenario. A further follow-up exercise will be held later in the year.

Trauma patients in North West London

A transition plan is in place for the north west London sector. This has been agreed with the trust, commissioners, London Ambulance Service and the London Trauma Office. During this time, ambulance staff will coordinate the transfer of major trauma patients in that area based on the injury they have sustained. This may be the local hospital, Charing Cross Hospital, St Mary’s Hospital or one of the existing three major trauma centres.

Background

There are about 1,600 major trauma cases each year in London (0.1% of all A&E cases). Most of these cases happen in central London.
Major trauma patients have complex injuries – either one very serious injury or a number of injuries which make management of these patients very challenging. They require expert care from a large number of different specialties to give them the best chance of survival and recovery. Until the launch of the London trauma system few of London’s hospitals were set up to provide this highly specialised care for major trauma patients.
The evidence shows that dedicated major trauma centres with expert teams of professionals can save more lives.

Plans to develop a trauma system for London were based on evidence which showed that most trauma patients in London and across the UK receive poor care. The National Confidential Enquiry into Patient Outcome and Death in 2007 found that over 50% of patients receive sub-standard care.

International comparisons showed London lagging behind other major cities in its treatment of trauma patients. Death rates for severely injured patients who are alive when they reach a hospital are 40% higher in the UK than in some parts of the US, where they have developed effective trauma systems.

In 2007, Lord Ara Darzi wrote a landmark review, Healthcare for London: A Framework for Action, which set out an ambitious vision to transform health and healthcare in London. The review recommended there should be greater centralisation of major trauma services based on networks that link local services with specialist centres.

From 31 January to 8 May 2009, Healthcare for London, held a major consultation, The shape of things to come, on plans to improve major trauma and stroke services. Following the consultation, a committee of PCTs decided to introduce four major trauma centres and better local services across London.

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